NPIMap

Organization Active NPI

UCSF Pediatric Dentistry

  • Pediatric Dentistry
  • San Francisco, CA
National Provider Identifier
1619041365
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
UCSF PEDIATRIC DENTISTRY
Practice address
707 Parnassus Ave
Box 0753
San Francisco, CA 94143-2210
Phone
(415) 476-3276
Fax
(415) 514-2561
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Charles Bertolami, D.D.S., DMEDSC
Title
Dean School of Dentistry
Phone
(415) 476-1323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

707 Parnassus Ave
Box 0753
San Francisco, CA 94143-2210

Mailing address

707 Parnassus Ave
Box 0753
San Francisco, CA 94143-2210
Phone (415) 476-3276

National Provider Directory

National Provider Directory
Tax ID family
UCSF Pediatric Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

707 Parnassus Ave
#753
San Francisco, CA 94143
Phone (415) 476-3276

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619041365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 PARNASSUS AVE",
            "address_2": "BOX 0753",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432210",
            "telephone_number": "415-476-3276",
            "fax_number": "415-514-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 PARNASSUS AVE",
            "address_2": "BOX 0753",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432210",
            "telephone_number": "415-476-3276",
            "fax_number": "415-514-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCSF PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERTOLAMI",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "DEAN SCHOOL OF DENTISTRY",
        "authorized_official_telephone_number": "415-476-1323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., DMEDSC"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.